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Awareness

I’m very passionate about mental health and abuse awareness, mainly due to my own expieriances. I am very open about my past, which I know is something that many do not like, but I do not see why I should stay silent – afterall that’s what the abusers told me to do and I can’t let them win can I?

I don’t want nor do I expect pity or sympathy. I do not deserve it, and I do not want it, what happened happened and I am only who I am today because of it. I do not want hugs and people saying they are sorry, what I want, what I fight for every day, is for OTHERS to feel safe that they will not be judged. What I want is to make it so that those who currently suffer in silence scared of what may happen if they open up know that they are not alone, and maybe make it so that they no longer have to fear judgement and blame.

I know that my work and my speaking out will not end abuse, discrimination and suffering, but if I can just let people know that they are not alone and do not have to suffer in silence and maybe if I can make a few people stop and think then I am happy with that. I cannot stop abuse, I cannot change the world, but maybe I can help to plant the seeds of change, plant that idea in to the minds of others, and then they can help that idea to grow until one day change can and does occur. Maybe one day the things which I fight will no longer exist, but I doubt that I will see that day. I can do so little, but it’s the best I can do, I just have to hope that human nature is not as bad as I fear and that these seeds if change and the glimmer of hope will take root.

I tell my story, my truth, not for pity, but for the hope that I can help to ignite change in this world. I know most will not believe this, but I know my truth and I hope that a few of you know this truth too. This is why I spend so long creating websites, writting letters, speaking in schools, raising money and trying to spread awareness. It’s an inconvenient truth I know, but it’s a truth that needs to be known, I cannot just sweep it under the carpet when I know that it could help others. So I fight and strive with the hope of helping, of making the suffering of others that little bit better that bit more bearable. I wish that this truth was not there, that it did not need to be spread, but it is and it does. And for this I am sorry

Nightmares refer to complex dreams that cause high levels of anxiety or terror. In general, the content of nightmares revolves around imminent harm being caused to the individual (e.g., being chased, threatened, injured, etc.). When nightmares occur as a part of PTSD, they tend to involve the original threatening or horrifying set of circumstances that was involved during the traumatic event. For example, a rape survivor might experience disturbing dreams about the rape itself or some aspect of the experience that was particularly frightening.

Nightmares can occur multiple times in a given night, or one might experience them very rarely. Individuals may experience the same dream repeatedly, or they may experience different dreams with a similar theme. When individuals awaken from nightmares, they can typically remember them in detail. Upon awakening from a nightmare, individuals typically report feelings of alertness, fear, and anxiety. Nightmares occur almost exclusively during rapid eye movement (REM) sleep. Although REM sleep occurs on and off throughout the night, REM sleep periods become longer and dreaming tends to become more intense in the second half of the night. As a result, nightmares are more likely to occur during this time.

How common are nightmares?

The prevalence of nightmares varies by age group and by gender. Nightmares are reportedly first experienced between the ages of 3 and 6 years. From 10% to 50% of children between the ages of 3 and 5 have nightmares that are severe enough to cause their parents concern. This does not mean that children with nightmares necessarily have a psychological disorder. In fact, children who develop nightmares in the absence of traumatic events typically grow out of them as they get older. Approximately 50% of adults report having at least an occasional nightmare. Estimates suggest that between 6.9% and 8.1% of the adult population suffer from chronic nightmares.

Women report having nightmares more often than men do. Women report two to four nightmares for every one nightmare reported by men. It is unclear at this point whether men and women actually experience different rates of nightmares, or whether women are simply more likely to report them.

How are nightmares related to PTSD?

A person does not have to experience nightmares in order to have PTSD. However, nightmares are one of the most common of the ‘re-experiencing’ symptoms of PTSD, seen in approximately 60% of individuals with PTSD. A recent study of nightmares in female sexual assault survivors found that a higher frequency of nightmares was related to increased severity of PTSD symptoms. Little is known about the typical frequency or duration of nightmares in individuals with PTSD.

Are there any effective treatments for nightmares?

Yes. There are both psychological treatments (involving changing thoughts and behaviors) and psychopharmacological treatments (involving medicine) that have been found to be effective in reducing nightmares.

Psychological Treatment

In recent years, Barry Krakow and his colleagues at the University of New Mexico have conducted numerous studies regarding a promising psychological treatment for nightmares. This research group found positive results in applying this treatment to individuals suffering from nightmares in the context of PTSD. Krakow and colleagues found that crime victims and sexual assault survivors with PTSD who received this treatment showed fewer nightmares and better sleep quality after three group-treatment sessions. Another group of researchers applied the treatment to Vietnam combat veterans and found similarly promising results in a small pilot study.

The treatment studied at the University of New Mexico is called ‘Imagery Rehearsal Therapy’ and is classified as a cognitive-behavioral treatment. It does not involve the use of medications. In brief, the treatment involves helping the clients change the endings of their nightmares, while they are awake, so that the ending is no longer upsetting. The client is then instructed to rehearse the new, nonthreatening images associated with the changed dream. Imagery Rehearsal Therapy also typically involves other components designed to help clients with problems associated with nightmares, such as insomnia. For example, clients are taught basic strategies that may help them to improve the quality of their sleep, such as refraining from caffeine during the afternoon, having a consistent evening wind-down ritual, or refraining from watching TV in bed.

Psychologists who use cognitive-behavioral techniques may be familiar with Imagery Rehearsal Therapy, or may have access to research literature describing it.

Psychopharmacological Treatment

Researchers have also conducted studies of medications for the treatment of nightmares. However, it should be noted that the research findings in support of these treatments are more tentative than findings from studies of Imagery Rehearsal Therapy. Part of the reason for this is simply that fewer studies have been conducted with medications at this point in time. Also, the studies that have been conducted with medications have generally been small and have not included a comparison control group (that did not receive medication). This makes it difficult to know for sure whether the medication is responsible for reducing nightmares, or whether the patient’s belief or confidence that the medication will work was responsible for the positive changes (a.k.a., a placebo effect).

Some medications that have been studied for treatment of PTSD-related nightmares and may be effective in reducing nightmares include Topiramate, Prazosin, Nefazodone, Trazodone, and Gabapentin. Because medications typically have side effects, many patients choose to try a behavioral treatment first.

What happens if nightmares are left untreated?

Nightmares can be a chronic mental health problem for some individuals, but it is not yet clear why they plague some people and not others. One thing that is clear is that nightmares are common in the early phases after a traumatic experience. However, research suggests that most people who have PTSD symptoms (including nightmares) just after a trauma will recover without treatment. This typically occurs by about the third month after a trauma. However, if PTSD symptoms (including nightmares) have not decreased substantially by about the third month, these symptoms can become chronic. If you have been suffering from nightmares for more than 3 months, you are encouraged to contact a mental health professional and discuss with him or her the behavioral treatments described above.

It’s estimated that around half the GP surgeries in England provide counselling services and support.
However, the availability of services varies depending on where you live and in some parts of the country, especially rural areas or small towns, NHS therapy is in short supply. You may have to wait a long time or travel to find something suitable.

The Improving Access to Psychological Therapies (IAPT) programme, which began in 2006, is putting thousands more trained therapists into general practices. The scheme will provide easy access to talking treatment on the NHS to everyone who needs it.

Your GP can refer you for talking treatment that is free on the NHS. This will usually be a short course of counselling or CBT from the general practice’s counselling service.
If counselling or CBT aren’t available at the surgery, your GP can refer you to a local counsellor or therapist for NHS treatment.
You may also be able to refer yourself for counselling. The IAPT programme means more and more primary care trusts (PCTs) are introducing the option of self-referral.
Self-referral means that people who prefer not to talk to their GP can go directly to a professional therapist. The service is already available in some parts of England. To find out what’s available in your area see our psychological therapy services directory.

If you have a serious mental health condition, such as severe depression, or a history of trauma or abuse, your GP can help you decide whether it would be better for you to see a different mental health professional, such as a clinical psychologist, psychotherapist, psychiatrist or a member of the local community mental health team.

If you can afford it, you can choose not to use the NHS and insted to pay for your therapy. The cost of talking therapy varies and a one-hour session can cost between £40 and £100! So in reality we are getting a SERIOUSLY good deal from the NHS… Other than the cost one of the drawbacks of going private is there are no rules governing who can dvertise talking therapy services, so it’s essential to check that the therapist is listed on one of the registers of approved practitioners. The advantage, however, is that you have more control over choosing a therapist as you can almost interview several until you find one who’s treatment suits you.

The main category of therapy offered by the NHS is talking therapy is a broad term. It covers all the psychological therapies that involve a person talking to a therapist about their problems. Howeverr, in some cases areas offer other forms, and it can also be possible to get funding towards a private therapist of a different type of therapy. Talking therapy includes cognitive behavioural therapy (CBT), cognative analitical therapy (CAT) and psychotherapy. Family therapy, couples therapy and group therapy are also offered, and can be placed under the umbrella term of talking therapy.

For those who find talking difficult creative therapies can aso be offered, these include such things as art therapy, body work, msic therapy and movement therapy.

We love the NHS… We currently are unable to work so get £360 a month to lie on, and as our rent alone is £575 that’s basically impossible… so without the NHS there is no way we could get treatment. In the past we have even had the hospitals, etc. send us and pay for taxi’s as we have issues getting outside and so couldn’t get there. I will admit that I have ad some bad experiances, bt these have mainly been with people rather than the service generally… and there are “bad” peopkle in every profession, doctors, nurses, psychs, etc are only human afterall. Over my life I have probably cost the NHS thousends of pounds (not exadurating either) and witout some of that treatment I would be dead… so without the NHS I’d either be dead or in so much debt that I’d wish i was dead…

Anyway, I wanted to take part, to help. We have been thinking a lot on eating disorders recsntly, in part as Sarah is struggling with ED thoughts at the moment which is effecting all of us in a negative light what it comes to food.

We had a slight ED slip-up last week, but these ARE part of recovery, and I wish to explain why this is and how it’s all a case of HOW you think or percieve it.

Instead of thinking about it as, “There goes all my hard work, screw it then, might as well eat and purge forever now!” think about it as what it was – A bump on the road to recovery.I mean noone said that the path to recovery was easy nor smooth

The all-or-nothing thinking of eating disorders can sabotage us in recovery, because it tells us that one slip-up immediately means we have failed. In reality, recovery is a process – a marathon and not a sprint.

So, you ate well for a week? So… 7 days, 3 meals a day. That means that you had 21 opportunities to fail, right? 21 chances to eat, then puke. …But you? You succeeded 20 of those times. 20 outta 21 ain’t bad.

Dissociation is a mental process, which produces a lack of connection in a person’s thoughts, memories, feelings, actions, or sense of identity. During the period of time when a person is dissociating, certain information is not associated with other information as it normally would be. For example, during a traumatic experience, a person may dissociate the memory of the place and circumstances of the trauma from his/her ongoing memory, resulting in a temporary mental escape from the fear and pain of the trauma and, in some cases, a memory gap surrounding the experience. Because this process can produce changes in memory, people who frequently dissociate often find their senses of personal history and identity are affected.

Most clinicians believe that dissociation exists on a continuum of severity. This continuum reflects a wide range of experiences and/or symptoms. At one end are mild dissociative experiences common to most people, such as daydreaming, highway hypnosis, or “getting lost” in a book or movie, all of which involve “losing touch” with conscious awareness of one’s immediate surroundings. At the other extreme is complex, chronic dissociation, such as in cases of Dissociative Disorders, which may result in serious impairment or inability to function. Some people with Dissociative Disorders can hold highly responsible jobs, contributing to society in a variety of professions, the arts, and public service — appearing to function normally to coworkers, neighbors, and others with whom they interact daily.

The depersonalization causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The depersonalization experience does not occur exclusively during the course of another mental disorder, such as Schizophrenia, Panic Disorder, Acute Stress Disorder, or another Dissociative Disorder, and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy).

Dissociative Fugue is one or more episodes of amnesia in which the inability to recall some or all of one’s past and either the loss of one’s identity or the formation of a new identity occur with sudden, unexpected, purposeful travel away from home.

Specific symptoms include:

The predominant disturbance is sudden, unexpected travel away from home or one’s customary place of work, with inability to recall one’s past.

Confusion about personal identity or assumption of a new identity (partial or complete).

The disturbance does not occur exclusively during the course of Dissociative Identity Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy).

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The length of a fugue may range from hours to weeks or months, occasionally longer. During the fugue, the person may appear normal and attract no attention. The person may assume a new name, identity, and domicile and may engage in complex social interactions. However, at some point, confusion about his identity or the return of the original identity may make the person aware of amnesia or cause distress.

The prevalence of dissociative fugue has been estimated at 0.2%, but it is much more common in connection with wars, accidents, and natural disasters. Persons with dissociative identity disorder frequently exhibit fugue behaviors.

The person often has no symptoms or is only mildly confused during the fugue. However, when the fugue ends, depression, discomfort, grief, shame, intense conflict, and suicidal or aggressive impulses may appear–ie, the person must deal with what he fled from. Failure to remember events of the fugue may cause confusion, distress, or even terror.

A fugue in progress is rarely recognized. It is suspected when a person seems confused over his identity, puzzled about his past, or confrontational when his new identity or the absence of an identity is challenged. Sometimes the fugue cannot be diagnosed until the person abruptly returns to his prefugue identity and is distressed to find himself in unfamiliar circumstances. The diagnosis is usually made retroactively based on the history with documentation of the circumstances before travel, the travel itself, and the establishment of an alternate life. Although dissociative fugue can recur, patients with frequent apparent fugues usually have dissociative identity disorder

Most fugues are brief and self-limited. Unless behavior has occurred before or during the fugue that has its own complications, impairment is usually mild and short-lived. If the fugue was prolonged and complications due to behavior before or during the fugue are significant, the person may have considerable difficulties–eg, a soldier may be charged as a deserter, and a person who marries may have inadvertently become a bigamist.

In the rare case in which the person is still in the fugue, recovering information (possibly with help from law enforcement and social services personnel) about his true identity, figuring out why it was abandoned, and facilitating its restoration are important.

Treatment involves methods such as hypnosis or drug-facilitated interviews. However, efforts to restore memory of the fugue period are often unsuccessful. A psychiatrist may help the person explore inner and interpersonal patterns of handling the types of situations, conflicts, and moods that precipitated the fugue to prevent subsequent fugue behavior.

The predominant disturbance is one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness.

The disturbance does not occur exclusively during the course of Dissociative Identity Disorder, Dissociative Fugue, Posttraumatic Stress Disorder, Acute Stress Disorder, or Somatization Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a neurological or other general medical condition (e.g., Amnestic Disorder Due to Head Trauma).

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Dissociative Identity Disorder

The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).

At least two of these identities or personality states recurrently take control of the person’s behavior.

Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

The disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play.

DDNOS
Dissociaitive disorder nos otherwise specified is when a person has some of the symptoms of a dissociaitve disoreder but do not fulfill any of the specific diagnosic criteria.

EMDR is an information processing therapy and uses an eight phase approach to address the experiential contributors of a wide range of pathologies. It attends to the past experiences that have set the groundwork for pathology, the current situations that trigger dysfunctional emotions, beliefs and sensations, and the positive experience needed to enhance future adaptive behaviors and mental health.

Basically, EMDR is a therapeutic technique in which the patient moves his or her eyes back and forth while concentrating on a problem or a traumatic memory. The therapist waves a stick or light in front of the patient and the patient is supposed to follow the moving stick or light with his or her eyes. The therapy was discovered by therapist Dr. Francine Shapiro while on a walk in the park.

Noone is really 100% sure of how EMDR actually works. A commonly proposed hypothesis is that dual attention stimulation elicits an orienting response. The orienting response is a natural response of interest and attention that is elicited when attention is drawn to a new stimulus.
Another theory is that humans naturally process memories and new informaion during REM sleep, but with traumatic memories this processing does not fully occur, leaving the memories unstored and still strongly connected to emotions and physical sensations. The idea here is that the eye movment in EMDR simulate REM sleep allowing the memory which is beng focused on to process.

However, there is a lot of empirical evidence for the effectiveness of EMDR, esspecially in the treatment of PTSD.